Struggle, Courage and Hope Fulfilled

From the book:
Miscarriages Can Be Prevented
By the founders of RIA

"Hi," the woman's cheerful voice answered. "You have reached the Copelands, John, Dianne, Peter, Sam and Heather*. We're not home right now, but if you'll leave a message, we'll call you back as soon as we can. Thanks." Then, the bubbling voice of a little girl, singing just enough off key to be truly adorable, "You are so beautiful to meeeeeeee!" BEEP.

The caller could not help but smile as he left his message. There is something about the voice of a happy child, the joyful exuberance, the youthful tone, so like music to the ears. How different that message would have been without Heather; empty in comparison, incomplete.

Like thousands of other children now alive and bringing joy to and receiving it from their families, Heather almost wasn't. Over the course of several years, her parents John and Dianne, diligently tried to start a family. Their effort, commitment and dedication in the face of severe difficulties, had repeatedly led them to the brink of emotional despair, revealing the depth of courage that love -- and the desire to love -- can create.

Getting pregnant was not a significant problem for Dianne. Giving birth, unfortunately, was. Before she bought our assistance, Dianne experienced multiple miscarriages (MM), what Doctors call "Recurrent Spontaneous Abortions" (RSA). Dianne had miscarried four times before giving birth to Heather. For no apparent reason, each child growing in her womb would appear healthy and normal one day, but be gone the next, leaving a feeling of emptiness and sadness and unfulfilled potential. The Copeland's began to fear the worst; that for them there would be no children -- flesh of their flesh and blood of their blood -- created out of their love and brought forth into this world.

"We tried to begin a family when I was 39," Dianne says. "We weren't sure I could get pregnant at that age, but my gynecologist said to try and see. Six months later I was pregnant."

John and Dianne were elated. "We told everybody," Dianne recalls. "Our doctor was thrilled for us. We felt so fulfilled and, well, successful. We began to dream of our new future. We weren't dewy-eyed romantics, but we were sure happy."

Twelve weeks into the pregnancy, Dianne began to spot. Slightly worried, she called her doctor who reassured her that some spotting was to be expected. Dianne, never the passive patient, wasn't so sure.

"What I read caused me to panic," Dianne remembers. "before I could think about doing anything about my condition, the worst occurred."

Dianne woke up saturated in her own blood. "I was totally panicked and frightened. We live in the high desert and we were one hour from the nearest hospital. John picked me up and carried me to the car. It was awful. The road was icy. We had to drive carefully. I thought we would never get there. I had an ultrasound (a test using sound waves that permits the fetus to be imaged) and it confirmed that I was losing our baby."

After the miscarriage, John and Dianne were in shock. It had all been so sudden and unexpected. Then, after the shock came the grief.

"We were numb with grief," Dianne recalls sadly. "plus, there was this overwhelming and profound sense of failure. I had to call everyone and tell them the news. All of our friends had children, and they had all been so happy for us."

The couple's grief was compounded by some people's thoughtlessness and lack of tact.

"They would say things to try and make us feel better like, `Oh, it is for the best: or, `Be thankful. This was nature's way of telling you the baby would have been deformed.' Or, `You were probably too active. Then there was `Oh, you can always try again.' We didn't see it as `God's will: We had lost a child. We had lost a dream." (Dianne suggests that the best condolence in such circumstances is a simple, "I'm so sorry. Is there anything I can do?")

Dianne's doctor gave her a physical, took some blood tests, and told Dianne she appeared healthy, that her reproductive organs seemed normal, and that the miscarriage was probably a fluke. His suggestion: "Try again."

Within a few months, Dianne was again happily pregnant. But after 6 weeks, She lost her second baby.

"It was harder on my husband than on me," Dianne says. "I was kept busy with taking care of my physical needs and dealing with my medical condition. In a sense that was a blessing because at least it took a little bit of my mind off of our loss. But John didn't have that `distraction' to fall back on. He grew very depressed. I became quite worried about him."

John's reaction is not surprising. As unexpected as it may sound, it is often the fathers who have the worst time after a miscarriage.

Faced with a patient suffering from RSA, many obstetricians are not quite sure what to do. Dianne's doctor fit this mold. Even though Dianne had no trouble conceiving, he referred her to a fertility clinic designed to help couples who could not get pregnant. (This is a frequent response by doctors faced with treating multiple miscarriage. Why? There are a lot of medical specialists who treat women with troubles conceiving, but few who focus on miscarriages. This is one of the inadequacies about the current system that we would like to help change.)

The physicians at the fertility clinic put Dianne through a battery of tests. One, a laparoscopy, involved inserting a small, flexible tube into Dianne's abdomen, through which the physicians were able to view her ovaries and fallopian tubes. Another test involved inserting dye into the uterus, which flowed into the fallopian tubes. This procedure could reveal tissue abnormalities, such as fibroid tumors, which might prevent the growing embryo from implanting. (During the first 10 weeks of gestation, the embryo anchors itself to the uterus. If it is unable to do so, a miscarriage will result.) Dianne also had an endometrial biopsy, in which a small tissue sample from her uterus was taken to Determine whether the depth and plumpness of her uteral lining would satisfactorily nourish the growing embryo. (see Chapter 2.)

"All of the plumbing was fine," Dianne now says. "The doctors could find no apparent physical reason to explain why I could not seem to carry a baby to term. so they put me on Clomid (a medication designed to help create a better environment for the fertilized egg to implant firmly in the womb) and told me to, `Try again.

Soon, Dianne was again pregnant. "As time went on, we grew more confident," she says. "Early in the pregnancy, I was taking hormone shots to help ensure that the my baby would implant firmly in my womb. That seemed to work well. When we passed the 12 week mark, it looked as if all our troubles were over. Then, after sweating out the amniocentesis (a test of the amniotic fluid to determine whether the fetus has any abnormalities or developmental disorders), we really began to feel good. We had a healthy, kicking son. We were certain we were home free. I let down my emotional guard. I began to allow myself to look for baby clothes. I bought some hand-made sweaters. John bought a baby backpack. We had never been so happy."

Dianne and John decided to take a relaxing vacation before the baby came. Dianne's gynecologist gave his ready consent. The baby was now 24 weeks along. He had a strong heartbeat, and both mother and son were doing fine. so, it was off to their favorite vacation spot, for a week of reading, long walks on the beach, and the simple joy of doing nothing.

Then, on the flight, Dianne grew worried. Her womb had gone eerily quiet. "I suddenly realized that I hadn't felt my baby kicking for many hours," She recalls. "It really scared me."

As soon as she and John arrived in Maui, they went to the nearest urgent care clinic they could find. The doctor listened for her baby's heartbeat with a stethoscope. He frowned. He could detect no signs of life. He then arranged to get Dianne into a nearby ultrasound clinic. She and John rushed over, drinking a large bottle of water in the car on the way, so that the test could be performed.

The technician took the test and then asked if I had been in an accident. I knew. I was heartsick. Then, he called my husband into the room and paid bluntly, 'Your baby is dead.'

"I felt like I was going to faint. The room went black-and white. I don't remember how we got out of there. I called my doctor cried into the phone, while my husband made arrangements for us to fly home. It was a nightmare. I was told I couldn't eat anything, that I would be going into labor within a few days as my body got about the task of expelling my dead baby.

"This was the lowest point of my life. Waiting for the plane, my husband and I went for a walk on beach. All I could think of was that I was carrying around a dead baby. We had picked out his name, Michael Joseph. And now he was gone.

"We saw all of those happy children playing in the surf, and pregnant women seemed to be everywhere. We were in utter despair. Then, John said with more vehemence than I had ever heard from him, `When we have our baby we are bringing our child back to play on this very beach!"

Hope was beginning to seem like an impossible dream to Dianne. She flew home and her doctor induced labor. "It took 12 hours. All that pain -- for nothing. Plus, I was in the maternity ward. All around me were the joyful wounds of new life being brought into the world. An attendant came in who didn't know what had happened. He smiled and asked if I had a boy or a girl.`I had a dead baby,' I said bitterly. The poor guy. His face fell and he almost ran out of the room."

Diane had a fourth miscarriage after 8 weeks of pregnancy. "I was told there was nothing wrong with me, that I was just having one of the worst unlucky streaks in medical history. But I didn't believe that. I knew there must be a reason that my doctors didn't understand."

Dianne read every book and article on miscarriages she could lay her hands on. "We saw it as this incredible and tragic puzzle that we had to solve." That wasn't all. In a common sentiment to moot couples suffering from multiple miscarriages, John says, "We were thinking about giving up. but before we did, we wanted to know that we had done everything physically possible to start a family. If by the end of 1992, we didn't have a baby, we were going to give up." (Indeed, creating a family was something the couple very deeply desired, and so John and Dianne adopted a little boy named Peter.)

By this time, they had learned of our clinic and wanted to see if we could help. We diagnosed Dianne's problem as immunologically based and commenced treatment, before, during and after Dianne's next pregnancy. One year later, out of the ashes of their hopes, John and Diane's dreams were fulfilled when Dianne joyfully gave birth to Heather, who weighed in at 7 pounds 2 ounces, after a normal gestation period.

Now, at age three, Heather brings smiles to the face of callers who hear her boisterous, "You are so beautiful to meeeeeee," on the family's telephone answering machine.

Mimi and Tom had a similar experience. Tom was Mimi's second husband. Now 37, Mimi had a 19 year old son from her first marriage, but she and Tom wanted to have a child of their own.

"We were worried that at my age I might have trouble getting pregnant or that the baby might have some problems," Mimi recalls. "But we never even gave a thought to miscarriage."

Contrary to her worries about conceiving, Mimi was pregnant within a weeks.

"We were elated," she recalls sadly. "We told everybody. We could hardly wait for our baby to be born."

Unfortunately, the baby was not fated to live. "We lost our child on Thanksgiving. It was one of the most devastating events of my life. I had experienced other losses; my mother, friends. But nothing compared to this. It is hard to explain how deep the pain went."

Like so many other women who have had a miscarriage, Mimi began to blame herself. "I felt like there was something wrong with me;' she says, the pain of her loss still evident in her voice. "The guilt was excruciating. I felt like I wasn't a complete woman and that I was being punished for having had 2 abortions, that I was defective. It was awful."

Tom recalls that the hardest thing was talking to people about it. "They just couldn't understand why we were so devastated "Nobody seemed to comprehend the depth of our loss."

Mimi echoes her husband's recollections. "I asked for bereavement leave at work and they wouldn't give it to me. That was deeply insensitive. The refusal told me that my bosses did not give our baby the validity for having been a being. That was a terrible blow."

About 6 months and a vacation later, with their doctor's approval, Tom and Mimi felt like getting pregnant again.

"This time I wasn't worried about getting pregnant, I was scared it might happen to us again," Mimi says. "so we didn't tell anybody, just in case. But once I passed the 5 week mark, I got very excited. Every day I would look at my panties. I just couldn't believe I wasn't bleeding. I felt as if I was crossing important lines. Every day I was a little more pregnant, a little closer to having a baby. We were at 8 weeks. We were able to see the baby on ultra sound, with a heart beat. My doctor was being very careful. I was convinced that this time it would be different."

Then, Mimi's worst fears were confirmed. "I was at work. I went to the bathroom and looked at my panties. I felt as if I had been kicked in the stomach. I couldn't believe it. I had started to spot. I called the doctor. He said not to panic. Most women spot a little. It could be no big deal. I went to the doctor, for a check up. The next day, we had another ultrasound. What had been a little baby was just a blob. By nighttime I was in full blown miscarriage."

This time, the devastation was even worse for Mimi and Tom. "That one hit me very hard. I called a friend who had 8 miscarriages and I asked her how to deal with it. She didn't know what to say. She told me that it hurts every time and she is right."

"We went to the doctor's office. He took a blood test. He said, `sometimes there are reasons. The best time to find out is to take tests during the miscarriage. Let's do this and maybe we'll get some answers: so, we did."

The doctor did the blood test. About a week later, he called Mimi and told her that she had an autoimmune problem. That's when she decided to consult with us at RIA. "I didn't feel comfortable with somebody who wasn't specialized in the area,"

Mimi says. "So, I started asking around. One of my friends had a friend who had seen Dr. Matzner. She got me the information."

Today, Mimi and Tom are the proud parents of a healthy baby boy, Tom, Jr. "He is our little miracle," Mimi says happily. "I can't even imagine life without him."

Are Heather, Tom, Jr. and the hundreds of other babies who have been born to mothers who had suffered recurrent miscarriages really miracles? Perhaps. But we offer something a little more predictable; effectively applied medical science, science that may be the answer to your yearnings, hopes, and desires, science that may allow you, like Dianne, Mimi, and the scores of other women we have assisted to overcome the impediments and achieve a successful birth.

Still, whether "applied science" or a "miracle," as a result of our diagnostic and treating capabilities at RIA, children are being born to women who only a few years ago could never have carried to term. In fact, Dianne recently had a second son named Sam.

"We are planning to take our children to Hawaii next month," She says happily. "And the very first thing we are going to do is go out to that beautiful beach, where once life seemed so devoid of color and so lacking in hope, and as John promised, we are going to play with our children in the sand."

(*Unless otherwise indicated, the names of patients in this book have been changed to protect their privacy. Some patient stories may be composites.)